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Pathology > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Which are more differentiated, benign or malignant neoplasms?

A

Benign neoplasms (they more closely resemble normal tissue)

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2
Q

Teratoma

A

Can be benign or malignant, arises from germ cells and contains derivatives from different germ layers

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3
Q

Adenomas

A

Beign epithelial tumors

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4
Q

Hamartoma

A

Disorganized tissue components, not a true neoplasm

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5
Q

Carcinoma

A

Malignant tumor derived from epithelial cells

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6
Q

Sarcoma

A

Malignant tumor derived from mesenchymal cells

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7
Q

Anaplasia

A

Dedifferentiation, a hallmark of malignancies

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8
Q

Pleomorphism

A

Variation between cells in overall size and nuclear morphology

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9
Q

Some frequently utilized tumor markers

A

PSA, Cytokeratin (epithelial cells), Vimentin (mesenchymal cells), Leukocyte common antigen/CD45 (hematopoietic cells), alpha-fetoprotein (liver cancer and germ cell tumors), carcinoembryonic antigen (GI and breast cancers)

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10
Q

Common sites of hematogenous metastasis

A

Lungs, liver, brain, bone marrow, adrenal glands

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11
Q

What tumor cell molecules aid in the process of local infiltration?

A

Proteolytic enzymes (e.g. collagenases) and cytokines

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12
Q

What does neoplasm grading assess?

A

Degree of anaplasia and proliferative capacity

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13
Q

What does neoplasm staging assess?

A

Extent of local growth and distant spread of a malignant tumor

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14
Q

TMN cancer staging system

A

Primary tumor size and extent of local invasion (T), presence or absence of lymph node (N) or distant metastases (M)

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15
Q

Paraneoplastic syndrome

A

Symptoms not directly attributable to tumor invasion

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16
Q

What symptom is a frequent manifestation of cancer and why?

A

Fever, because tumor cells release pyrogens as do responding inflammatory cells

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17
Q

Wasting syndrome

A

Seen in cancers, characterized by anorexia, weight loss, cachexia (due to TNF and other cytokines)

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18
Q

What paraneoplastic syndromes are most commonly seen with small cell carcinoma of the lung?

A

Cushing syndrome (ACTH) and inappropriate antidiuresis (ADH)

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19
Q

What paraneoplastic syndrome commonly arises in patients with squamous cell carcinoma of the lung?

A

Hypercalcemia due to synthesis of a PTH-like molecule

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20
Q

What paraneoplastic syndromes are common in germ cell tumors?

A

Precocious puberty, gynecomastia, oligmenorrhea (excess gonadotropins)

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21
Q

Common neuromuscular paraneoplastic symptoms

A

Subacute motor neuropathy (LMN weakness), ALS, sensorimotor peripheral neuropathy, dermatomyositis, polymyositis

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22
Q

Eaton-Lambert syndrome

A

A myasthenia-like disorder, strongly linked to small cell lung carcinoma

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23
Q

What paraneoplastic syndrome is commonly associated with renal cell carcinoma?

A

Polycythemia (erythtrocytosis) due to excess synethesis of erythropoietin by the tumor

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24
Q

Trousseau syndrome

A

Thrombosis secondary to pancreatic carcinoma

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25
Q

What paraneoplastic syndrome is commonly seen with metastatic mucin-producing adenocarcinomas and acute promyelocytic leukemia?

A

Disseminated Intravascular Coagulation (DIC)

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26
Q

What is the most frequent cause of cancer death in the US?

A

Cancer of the lung

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27
Q

Behind lung cancer, what tumors are frequently seen in men?

A

Colorectal and prostatic carcinomas

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28
Q

Behind lung, what other tumors are commonly seen in women?

A

Breast and colorectal carcinomas

29
Q

List the infectious agent associated with each: cervical cancer, lymphoma, vascular tumor, hepatocellular carcinoma

A

HPV, EBV, HHV (Human Herpes Virus), Hep B/C

30
Q

Acromegaly

A

Excess GH production, can be a paraneoplastic syndrome

31
Q

Acanthosis nigricans

A

Brown to black hyperpigmentation of the skin (typically in body folds), can be a paraneoplastic syndrome

32
Q

Leser-Trelat sign

A

Multiple seborrheic keratoses (pigmented skin lesions), can be a paraneoplastic syndrome

33
Q

What phosphorylates Rb and what is the effect of this?

A

CDKs, the result is release of E2F which increases production of proteins that drive cell through S phase

34
Q

What family of proteins are p16INK4A and p21WAF1/CIP1?

A

CKIs (inhibit cell cycling)

35
Q

What type of proteins are MSH2 and MLH1?

A

DNA mismatch repair proteins

36
Q

3 major DNA repair pathways

A

Mismatch repair, base excision repair, double-strand break repair

37
Q

DNA damage activates what proteins?

A

ATM and ATR (which activate p53)

38
Q

80% of human tumors have high levels of what?

A

Telomerase

39
Q

What causes chronic myelogenous leukemia?

A

Translocation of the ends of the long arms of chromosomes 9 and 22 creating a fusion protein (BRC-ABL)

40
Q

What is the most common genetic abnormality among human cancers?

A

Mutant p53

41
Q

Why is p53 haploinsufficient (ie dominant negative)?

A

Because it is a tetramer which requires all four subunits to be functional

42
Q

What does PTEN do?

A

Converts PIP3 to PIP2

43
Q

What DNA modification may lead to activation of tumor viruses?

A

DNA methylation

44
Q

What histone modification leads to a decrease in gene expression?

A

Histone deactylation

45
Q

Cause of malignant lymphoma

A

Chromosomal rearrangement (t(14:8)) that leads to overexpression of Bcl-2 (anti-apoptotic)

46
Q

TGF-beta

A

A short-acting cytokine that tends to suppress tumor development (but can be used by tumor cells to evade host defenses)

47
Q

Between clonal and heterogenous tumors, which is typically malignant?

A

Clonal

48
Q

What allows cancer stem cells to escape chemotherapy

A

A low mitotic rate

49
Q

What family of enzymes (among others) do tumor cells use to penetrate basement membranes?

A

Matrix Metalloproteinases (MMPs)

50
Q

Invadopodia

A

Protrusions from tumors which they use to penetrate basement membranes

51
Q

The only known human tumor virus that is an oncoretrovirus

A

Human Thymus-Leukemia Virus 1 (HTLV-1)

52
Q

Most viruses that cause human cancers are what kind of viruses?

A

DNA viruses

53
Q

Which HPV serotypes contain major oncoproteins

A

16, 18, 31, 33, and 35

54
Q

Which HPV serotypes are common but not cancerous?

A

6 and 11

55
Q

What are the major oncoproteins of HPV and what does each do?

A

E5 activates epidermal growth factor receptor, E6 inactivates p53, E7 inactivates Rb

56
Q

Besides cancers of the cervix, what cancers do HPV cause?

A

Squamous carcinomas of the male genital tract, oral cavity, and pharynx

57
Q

What type of virus is EBV?

A

A human Herpesvirus

58
Q

What does EBV do?

A

Infects and transforms B lymphocytes

59
Q

What are two main EBV proteins and what does each do?

A

Nuclear antigen (EBNA) helps maintain viral activity, and Latency-associated Membrane Proteins (LMPs) affect TNF receptor signaling

60
Q

What cancers is EBV associated with?

A

Malignant lymphoma (think Africa), Burkitt lymphoma, Hodgkin lymphoma (nasopharyngeal carcinomas), and also lymphoproliferative disorders

61
Q

What type of virus is hepatitis?

A

Hep B is a DNA virus, Hep C is a RNA virus

62
Q

Chronic infection is the rule for one hepatitis virus and the exception for the other, which is which?

A

Chronic infection is the rule for HCV and the exception for HBV

63
Q

How might HBV and HCV infections lead to hepatocellular carcinomas?

A

Repeated cell division leading to mutation, and/or HBV X-protein might inactivate p53 (HCV might also manipulate NFkB)

64
Q

What cancer does Human Herpesvirus 8 cause?

A

A vascular tumor called Kaposi sarcoma (KS)

65
Q

What patient population is HHV8 infection common in?

A

HIV positive patients

66
Q

How does HHV8 cause cancer?

A

It encodes proteins that inactivate p53 and Rb

67
Q

What type of cells does HTLV-1 infect?

A

Certain T lymphocytes

68
Q

How does HTLV-1 cause cancer?

A

One of its proteins (Tax) promotes cell division and decreases production of p53

Pathology (9 decks)

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